capacity + consent

Question 1

5 criteria for assessing capacity

Answer 1

-understand info given
-weigh risks and benefits of the specific decision
-communicate their decision
-retain the decision that they have made and communicated
-apply that decision or be aware of how this may be applied (e.g. I will need to attend the pre op appointments before surgery, I will need to open the door to allow carers into my home)

if they cannot any 1 of 5 then they lack capacity

Question 2

what are the principles for adults with incapacity?

Answer 2

1. The intervention must benefit the adult
2. This benefit cannot reasonably be obtained without the intervention
3. Takes account of the adults previously or currently expressed wishes
4. Consults with relevant person (family, friends, ccarers, powers of attorney, Guardians)
5. The adult should be encouraged to utilise residual capacity (e.g. may not be able to decide an accpeting antibiotic but should be allowed to choose their lunch)

Question 3

who completes section 47 certificate of incapacity?

Answer 3

-completed by a doctor

Question 4

what is section 47 certificate of incapacity?

Answer 4

-a form completed by a doctor to authorise non emergency treatment in an adult who lacks the capacity to give/ refuse consent

Question 5

what does section 47 certificate of capacity not authorise?

Answer 5

DOES NOT authorise:
-use of force
-restraint

Unless immediately necessary and only for as long as necessary

Specifically for the transport of someone

Question 6

when must power of attorney be granted?

Answer 6

while person retains capacity

Question 7

who can guardianship be used for and who can it be applied for by?

Answer 7

-can be applied for by family, friends or local authority on behalf of an adult who has already lost capacity

Question 8

who must assess guardianship?

Answer 8

Requires assessment carried out by:
-two medical professionals (usually GP and a senior psychiatrist) and a Mental Health Officer
-Granted by Sherriff Court

Powers include; Welfare, Financial, Financial including property or a combination of above

Question 9

can guardianship place an adult in hospital or treatment against their will?

Answer 9

no

Question 10

what is the mental health (care and treatment) act?

Answer 10

provides legal framework for the treatment of mental disorder or the consequences of mental disorder in a person who lacks capacity to give consent

Question 11

who can apply/ remove the emergency detention certificate and how long does it last?

Answer 11

Can be used by any doctor more senior than an fy1- doctor with a licence to practice BUT can only be removed by a senior psychiatrist

Lasts 72 hours

Question 12

what is the criteria for the emergency detention certificate?

Answer 12

-Likely to have a mental disorder
-Impaired decision making
-Risk to themselves or others
-Hospital detention is urgent
-Short term detention would take too long

Question 13

who can the short term detention certificate be applied by?

Answer 13

can only be applied by a senior psychiatrist AND mental health officer

Question 14

how long does a short term detention certificate last?

Answer 14

28 days

Question 15

Criteria for a short term detention certificate?

Answer 15

-Likely to have a mental disorder
-impaired decision
-Detention in hospital is necessary for assessment and treatment
-Risk to themselves or others
-Cannot be treated voluntarily

Question 16

who can the cumpolsory treatment order by applied by?

Answer 16

-senior pychiatrist and an MHO with the approval of a special tribunal hearing

Question 17

how long does a compulsory treatment order last?

Answer 17

Lasts 6 months initially but can be applied for a year at a time if needed longer term, Regularly checked by MHS tribunals

Question 18

what is an advanced statement?

Answer 18

Written up by individuals while well and able to make capacious decisions

Outlines a persons wishes and beliefs about treatment they may need in the future.

Should be read and carefully considered by medical professionals but it is not always possible to follow an advanced statement

Can be utilised for both mental + physical health

Question 19

who signs and advanced statement?

Answer 19

-the individual and a health/social care worker if possible

Question 20

how long until an advanced statement recommended to be reviewed?

Answer 20

every 6-12 months

Question 21

Criteria for a compulsary treatment order (CTO)?

Answer 21

-diagnosed with mental health disorder
-impaired descicion making
-risk to themselves/ others
-treatment available
-cannot be treated voluntarily